Targeted and immunotherapy drugs for cervical cancer
You might have targeted and immunotherapy drugs as part of your treatment for cervical cancer.
Targeted cancer drugs work by targeting the differences in cancer cells that help them to grow and survive.
Immunotherapy uses our 
to fight cancer. It works by helping the immune system recognise and attack cancer cells.
Some drugs work in more than one way. So, they are targeted as well as working with the immune system.
When you might have targeted and immunotherapy drugs
Whether you have targeted therapy and immunotherapy will depend on:
- the type of cervical cancer you have
- how far the cancer has grown (the stage)
- treatment you may have already had
- whether your cancer has certain proteins
Targeted cancer drug
You might have a targeted drug with chemotherapy for stage 4B cervical cancer that:
- has come back (recurrence)
- doesn’t respond to treatment (persistent)
Immunotherapy
You might have immunotherapy with or without a targeted drug and chemotherapy for cervical cancer that:
- has come back and is localised (recurrence)
- doesn’t respond to treatment and is localised (persistent)
- is advanced (metastatic)
Tests on your cells
Doctors look for certain proteins on the surface of your cervical cancer cells. They help the cells to grow and divide. They look for the:
vascular endothelial growth factor (VEGF) protein - programmed cell death ligand 1 (PDL-1) checkpoint protein
They usually test a sample of your cervical cancer tissue from when you were first diagnosed. Or from your operation if you had one.
The results of the tests show whether a targeted cancer drug or immunotherapy is suitable for you.
If your cancer has a particular protein on its surface, your doctor will call it positive for the protein. For example, PDL-1 positive.
Types of targeted and immunotherapy drugs for cervical cancer
Bevacizumab
Bevacizumab is a targeted cancer drug used for cervical cancer. It targets the VEGF protein and blocks it. Vascular endothelial growth factor (VEGF) is a protein on the surface of cancer cells. This protein helps cancers grow blood vessels to get food and oxygen from the blood. All cancers need a blood supply to be able to survive and grow.
By blocking this protein, bevacizumab stops the cancer from growing blood vessels, so it is starved and can't grow.
This treatment is also called an anti angiogenesis (anti-VEGF) treatment. This means it interferes with the development of a blood supply.
You have bevacizumab with one of the following groups of chemotherapy drugs:
- paclitaxel and carboplatin
- paclitaxel and cisplatin
You usually have it for stage 4B cervical cancer that:
- has come back (recurrence)
- doesn’t respond to treatment (persistent)
You can have this treatment if you:
- are well enough
- haven’t had treatment with bevacizumab or any other anti-VEGF drug before
Pembrolizumab
Pembrolizumab is an immunotherapy drug that targets and blocks a checkpoint protein called PD-1 on the surface of T cells. Checkpoint proteins are found on the surface of cells. PD-1 is found on the body's T cells and PD-L1 on normal and often cancer cells. PD-1 means programmed cell death protein 1, and PD-L1 means programmed cell death ligand 1.
PD-L1 usually binds with PD-1. When PD-L1 on a cancer cell binds with PD-1, it prevents the T cell from recognising the cell as a cancer cell. The T cell sees it as a normal cell and leaves the cell alone. So, it prevents the T cell from killing the cancer cell.
Blocking the binding of PD-L1 to PD-1 with drugs called immune checkpoint inhibitors allows the T cells to recognise and kill cancer cells.
You have pembrolizumab with or without bevacizumab and chemotherapy. The chemotherapy drugs include one of the following groups:
- paclitaxel and carboplatin
- paclitaxel and cisplatin
You usually have it for cervical cancer that:
- has come back and is localised (recurrence)
- doesn’t respond to treatment and is localised (persistent)
- is advanced (metastatic)
You may have this treatment if:
- your cancer cells are PDL-1 positive
- you haven’t had previous chemotherapy
- you haven’t had treatment with bevacizumab or any other anti-VEGF drug before
- you haven’t had treatment with another immunotherapy drug that targets PD-1 or PDL-1
- you are well enough
- you don’t have brain metastases or leptomeningeal metastases that are causing symptoms
Are these drugs available in the UK?
New cancer drugs are licensed for use in a particular way. For example, a drug might have a license to treat a particular stage of cervical cancer.
Once a drug has a license, several independent organisations approve the new cancer drugs before doctors can prescribe them on the NHS.
In England, the National Institute for Health and Care Excellence (NICE) decides which drugs and treatments are available on the NHS.
In Wales, the All Wales Medicines Strategy Group (AWMSG) advises NHS Wales. They generally follow NICE decisions but can also issue their own guidance.
The Scottish Medicines Consortium (SMC) advises NHS Scotland. Its decisions are separate from decisions made by NICE.
Not all targeted and immunotherapy drugs are available throughout the UK. It might depend on where you live whether you can have a certain drug. Your doctor can tell you what drug is available for you.
How you have targeted and immunotherapy treatment
You have treatment through a thin short tube (a cannula) that goes into a vein in your arm each time you have treatment.
Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment.
Side effects
Everyone is different and the side effects vary from person to person. The side effects you have depend on:
- which drug you have
- whether you have it alone or with other drugs
- the amount of drug you have (the dose)
- your general health
A side effect may get better or worse during your course of treatment. Or more side effects may develop as the treatment goes on. For more information about the side effects of your treatment, go to the individual drug pages.
